| NPI | 1134362304 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: UT 8622599-1205) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MN 53292) |
| Enumeration Date | 2009-04-16 |
| Last Update Date | 2018-03-17 |